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N E Quo ^ S.'.-.., <br />Goad Life Great Serv.ce. <br />Ot,MTN,NT Of eaVnNUt <br />Notice of State Tax Lien <br />202606532 <br />Nebraska Secretary of State <br />-FILED- <br />File #: 2610147282-2 <br />Date Filed: 10/14/2026 8:59 AM <br />This Notice of State Tax Lien is issued by the Nebraska <br />Department of Revenue for unpaid taxes administered by the Tax <br />Commissioner. Taxes, including penalties, interest, and costs, <br />which are shown below, are due from the taxpayer and remain <br />unpaid after demand.These taxes are a lien for all property located <br />in the county and rights to property owned by the taxpayer or <br />acquired before the expiration of this lien. This lien will expire and <br />become unenforceable 10 years after the date of recording if no <br />continuation statement is recorded on or prior to the expiration of <br />the previous lien or continuation statement. <br />PLEASE DO NOT WRITE IN THIS SPACE <br />Nebraska ID Number <br />43175627 <br />Federal ID Number <br />NO FEIN <br />Lien Serial Number <br />12638892 <br />Lien Filed With: <br />4 Register of Deeds County Clerk <br />Social Security Number <br />XXX-XX-9052 <br />Spouse's Social Security Number <br />NO SPOUSE SSN <br />Date of Lien <br />October 1, 2026 <br />Lien Type• <br />County <br />HALL <br />El Original Continuation <br />Corrected <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />ELENA C HERNANDEZ <br />1322 W 8TH STREET <br />GRAND ISLAND NE 68801 <br />Tax Program <br />Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />Interest <br />Costs <br />Total Due <br />Individual <br />2025 <br />05/05/2026 <br />$317.00 <br />$15.85 <br />$11.74 <br />$344.59 <br />Total <br />$344.59 <br />I certify that the Nebraska Department of Revenue has complied with the laws of the State of Nebraska in determining the amount shown to be due, <br />and that the taxpayer has failed to pay the amount due after demand. This Notice of State Tax Lien is an effective lien and serves to continue the priority of <br />the States interest in the affected property of the taxpayer. <br />sign s ,N LQ44 Collections 10/01/2026 402-471-5729 <br />here 0 Preparers Signature Title Date Phone Number <br />1 Jtho �s (AV Revenue Supervisor 10/01/2026 <br />Authorized Signature 11 Title Date <br />4-494-1974 Rev 8-2018 Supersedes 4.949.1974 Rev 8-2013 <br />C0544-2188 10/14/2026 8:08 <br />ry <br />m <br />0 <br />cu <br />r- <br />C <br />m <br />tr- <br />1< <br />m <br />tr <br />n <br />to <br />N <br />m <br />fD <br />n <br />n <br />CD <br />rt <br />ty <br />n <br />0 <br />rh <br />rn <br />rr <br />w <br />rr <br />fD <br />